Just a few years ago, external male urinary catheters, or condom catheters, were generally retained on a penis of an incontinent male with an adhesive tape of one type or another. The adhesive coated catheter disclosed by Conway et. al. (U.S. Pat. No. 4,475,910 reexamined and reissued as U.S. Pat. No. RE33,206) provided incontinent males with a self-sealing external catheter which required no tape, was easier to put on, and had functional advantages over earlier catheters, such as reduced leakage due to the improved seal between the catheter and the penis. The strapless catheter of Conway et. al. has proven to be a great commercial success and has become the catheter of choice for many men who are incontinent and who must wear an external urinary catheter.
Even the adhesive coated catheter of Conway et. al., however, is troublesome with respect to males having a "recessive" penis. A recessive penis is one wherein a relatively small length of penis protrudes from the pelvic area. In such situations, very often, less than one inch of penis presents itself for attachment of a catheter. Current "tape-on" and "strapless catheters," both of which were mentioned above, are extremely difficult to attach to males having a recessed penis. Often the only alternatives are diapers or the use of an internal catheter.
The strapless catheters on the market have the adhesive sandwiched between successive rolls of the catheter. As the catheter is unrolled, the inner surface comes into contact with the penile surface and is then "squeezed to seal." The adhesive on these catheters is positioned so that they will adhere to the penile shaft behind the glans. The glans is positioned within a non-adhering frontal section which is cone- or bulb-shaped. The recessive penis does not extend far enough out so that the strapless catheters can be unrolled far enough to bond sufficiently to the penile shaft. Because of the short length, it is also extremely difficult to tape a catheter securely to the recessive penis. The problem is well known and various solutions have been tried.
In one solution, a glans "cap" external catheter is shaped like a cup to fit only over the glans. It has been unsatisfactory, however, because a glans-only seal does not withstand body movement and urine pressure unless the adhesive is made so aggressive as to cause pain and damage on removal.
Other solutions have attempted to better install an ordinary strapless catheter on a recessed penis. One approach has been to partially unroll the strapless catheter and then position it over the recessed penis. This is a difficult installation procedure and results in another significant problem. Namely, as the strapless catheter is installed, it is common to pull out the recessed penis from its pelvic folds so as to be able to unroll enough of the strapless catheter to form a functional seal. Unfortunately, after installation, the penis retracts back into its pelvic recess and surrounding pelvic flesh actually push against the remaining unrolled roll on the catheter and essentially roll it back off the penis. To help prevent this, nurses have actually been instructed to try to cut off the remaining ring roll with a pair of scissors after the catheter is installed!
Another approach has been to use ostomy pouches to catheterize recessive penis patients. A flat circular adhesive material is sealed to the pelvic area around the penis and then the ostomy bag is adhered to that instead of the penis. Results are very unsatisfactory because the pelvic surface is difficult to adhere to and leakage is common. Ostomy hookups are also expensive.
The present invention overcomes the problems associated with installing an ordinary strapless catheter on a recessed penis.